At 70, I've been rather healthy and have not had a need to utilize - as yet - my Medicare or Medicaid. At age 62, due to lack of work, I had to take early retirement and begin Social Security. I also qualified for food stamps. I'm not married; no children; no relatives. For awhile I didn't participate in Medicare Plan B because I simply couldn't afford to. Then I realized that there was help to pay for the premiums called the Medicare Savings Program, which I qualified for.
This in turn led me to more help via Medicaid. I assumed, wrongly it would seem, that I qualified for full Medicaid help. The term they have used on the yearly renewal papers I receive for Medicaid is "Medically Needy." I assumed I would not have to worry about any "deductibles" should the need arise since I was both Medicare and Medicaid. I wrongly didn't investigate any further since I didn't have any medical needs.
I now have some eye and other issues that need to be taken care of. So I looked into "Medically Needy." Imagine my surprise when it said I must "share the cost" because some bureaucrat decided my income "exceeded" the Medicaid limits!
First, the ONLY income I have is Social Security and that is $8,460 A YEAR (2018) I have no other assets; I don't own a car; I don't have other means of support; I don't own a home; I must pay rent from only $705 SS a month (rent goes up each year; currently it's $500 month, one of the cheapest in town). Utilities are always high no matter how much I conserve in this old apt. complex; my city has the highest rates in the state of Florida. I have qualified for a very low rate of Internet for a couple of years but once that program ends, I won't be able to afford ANY Internet. There is no suitable senior public housing. I have one credit card with a low limit that I am attempting to pay off but must use for necessities (dish liquid, toilet paper, etc) sometimes or other household emergencies. I get $192 month in food stamps and that may sound like a lot but with always rising food costs, it really isn't. I often use the credit card to pay for food. And round and round I go. I'm lucky if I "clear" $10 each month in "cash." Sometimes it's less than that, depending on utilities.
Really, if anyone should qualify for full Medicaid and prescriptions, I think I would be a likely candidate. So what do I do now? They've put me at "Medically Needy" for several years! How can I correct this? Getting anyone on the phone in years past has been a nightmare - one cannot stay on hold, you're repeatedly disconnected and forced to call back FOR HOURS.
I need to use the system in the coming weeks and this is worrying the heck out of me. I don't have any extra cash to pay outright to any doctor until Medicaid decides to kick in for that one month.
I am at a loss to explain why someone could see that I somehow exceeded the poverty limits for Medicaid. My poverty level "income" is right there on my annual renewal forms! If anyone can explain this, please do. What am I missing? How to get real help with this on Monday?
What happened in practice? DHS/Medicaid did not send me anything, and neither did SSA, there was no auto enrolling, no notifications. I found out later when I went to pick up a $2,000 prescription (generic) and Medicaid did the pre-auth, then refused to pay for it and said for Part D to be billed, which I did not have.
You can apply for Extra Help online if you haven't: www.ssa.gov/benefits/medicare/prescriptionhelp/
I received it in 1 business day after applying, but I had no idea it existed. My monthly Part B premium is now being paid for by Michigan, but that is because I finally got a new DHS worker who actually does work.
My income is similar to yours, my rent, I have no assets, etc. I was enrolled in a MSP and my SS income is slightly over the cut-off too, my "spend down" is $989/month. I have no idea how I would ever reach this amount either. I am also "Medically Needy" and was able to get Medicaid when there was open enrollment, and my co-pays for doctors, hospitals and prescriptions was $0.
But in the case of these other programs I was eligible for, my DHS state worker was not available either, like yours. At all. I have a new one now, but even she is trying to complain that I am at the "end of her line of accounts because she has 900 other people in front of me who were here first." But when I started receiving SS, they were very fast in cutting my Food Stamp benefits from $189/month to $15. That they were right on top of.
2. Instead of calling DCF, go to your local office, in person
So, I already had the food stamps - and then I applied for the Medicare Savings Program, and then I applied for Medicaid - it's all done at the same site within your account. When I received the "Medically Needy," I assumed it was for the full Medicaid. Someone in the office who looks over these online applications at the ACCESS site (the renewal site for my account) is the one who determined that I inexplicably exceeded the poverty level which makes no sense at all since I was already on food stamps and qualified for the Medicare Savings Program.
I just took a look at the link you provided and then other links they provided and while Florida didn't expand Medicaid, I STILL qualify according to their poverty level figure (which is around $11k a year for a single person; as mentioned, I'm far below that).
Thank you. I'll call Monday but dealing with the people involved directly has never been easy.
I think you should fill out an application for Florida Medicaid